SCREENINGS!

We’ve been BUSY this month here at Skill Builders. Twice a year, we conduct screenings at local preschools. Screenings are used to determine whether or not a child presents within the average range, as compared to same-aged children. We like to think of screenings as a way of catching kids before they fall. Identifying potential areas of weakness or delays early on can help start the intervention process sooner, rather than waiting until academic or social problems arise. A screening is not a formal assessment, but a tool used to identify whether a formal evaluation is needed. Screenings are an important part of well-child health care, and can be a valuable tool for both parents and teachers

So what is a screening?

Prior to the screening, we collect a brief case history form from the parents that alert us to any pertinent medical history or diagnoses, as well as any previous therapy services. This form also allows for parents to express concerns or ask questions so we can take an extra look at certain skill areas.  

Additionally, we often collect a short questionnaire from the child’s classroom teacher to get an idea of how the child presents in class, as well as any areas of concern that the teacher might have. 

Each screening takes approximately 15-20 minutes. Clinicians will often pull children in groups of 2-3 in order to make them more comfortable. We use a combination of standardized assessment tools, as well as our own clinical observations as we engage the children in tasks that showcase various skills. The activities are play-based and fun, and our goal is for the children to perceive the experience as just “playing with a new teacher”! 🙂

After the screening is over, the clinician will write up a short report to summarize the findings. If areas of concern are identified, a formal evaluation may be recommended. Sometimes, if a skill area appears “on the cusp”, we recommend that a child’s skills be monitored, and re-screened in 6 months. If all looks age-appropriate, we recommend that children still participate in screenings once a year until they reach elementary school. At Skill Builders, we offer the option of scheduling a brief phone call with the screening therapist to ensure parents understand the results, and to address any additional questions. 

Skill Builders offers three different types of screenings:

1.       Hearing Screening

A Pure Tone Test is a “pass/fail” test that determines if a child can detect a range of frequencies in each ear. If the child passes, it is presumed that there is no hearing loss. If the child is not able to detect one or more frequencies, a comprehensive evaluation conducted by an audiologist is required. If a child is not cooperative, or does not appear to understand the task, we may recommend that he have a repeat hearing screening at his pediatrician’s office.

2.       Speech and Language Screening

*Articulation

*Oral Motor Skills

*Expressive Language

*Receptive Language

*Auditory Processing

*Fluency

*Voice

*Pragmatic/Social Languag

3.       Occupational Therapy Screening

*Fine Motor

*Pre-Writing Skill Development

*Visual Perceptual Skills

*Sensory-Motor Processing

*Balance

*Bilateral Coordination

*Frustration Tolerance

*Body Awareness

*Visual Attention

We love doing screenings because it allows us private practice clinicians a glimpse into classroom life, and it gives us a good refresher of what typical development looks like. Skill Builders enjoys partnering with area schools and parents to promote early identification and intervention in important areas of development. 

If your child’s preschool is interested in offering screenings, please contact Cari Syron at cari@skillbuildersllc.com.

 

-Elizabeth Clark McKenzie, MS, CCC-SLP

Cause and Effect

One of the earliest developing skills and interests of a child comes with cause and effect. We talked about some important toys that assist in children’s development previously, but wanted to delve a little deeper into these toys that have all the “bells and whistles” that may be so interesting to your child. These are toys such as ball poppers,
door poppers, and anything that makes noise or does something “exciting” once a button or switch is activated. It has been noted that these toys decrease interaction between parents and children since the kids can play with them on their own. But we have some ideas on how to make these toys more interactive and reciprocal.

In December 2015, a study was published that cautioned parents against the use of cause and effect toys for language development. The study (from JAMA Pediatrics) was conducted on 26 families with children ages 10 months to 16 months. The families received a variety of toys, which included a set of noisy, flashy cause and effect toys; wooden puzzles, shape sorters, and blocks; and board books with basic concepts. Results yielded information that suggested books were the most interactive and language-rich activity, followed by traditional toys (puzzles/blocks). Least interactive were the cause and effect toys. As SLPs, we are definite advocates of book reading at a very early age – start right away! Books have the power to teach concepts, character and story development, sequencing, and so much more. What a great way to get started on early literacy! But we’re not always able to sit with our kids and read all day. Playing with a variety of toys is great too. Traditional toys definitely teach great skills, including problem solving, turn-taking, fine motor development, and others. So what about those noisy, flashy toys that you already own and your child absolutely adores? Here are some suggestions for more interactive play:

1. Turn taking: facilitate a back and forth play with a turn taking routine. You can use language, like “your turn!” and “my turn!” to start this concept early. Of course, with the little ones, it doesn’t have to be such a rigid back and forth; instead, be playful!
2. Eye contact: wait for your child to look at you before turning the toy back on (most of them have an on/off switch that you can manipulate and control). Eye contact often indicates some form of communication and an awareness that you can give them what they want – another turn!
3. Requesting: to work on early-developing sounds, you can practice “ah” (for “on!”) and “m” (for “more”).
4. Problem solving: give your child wait time and see if they can figure out how to operate a button/switch or to pick something out (I’ve seen kids exhibit very nice fine motor skills this way).
5. Narration: depending on the toy, you may be able to talk about an object. For example, in a toy that has different animals you might be able to say where they live, what sounds they make, what they look like, and other attributes.
6. Increased utterance length: once your child has begun to use one word at a time, you can model phrases: “want more” “ball in” “go ball” “go in.” Typically, children begin to combine two words around 18 months.
7. Prepositions: in, on, under – all these represent locations that are likely possible to talk about with any toy.

The aforementioned suggestions will take some degree of modeling. Don’t just expect your child to do it independently. Some cues include gestures (like pointing), verbal cues (like short, easy directions – “ball in”), and hand over hand assistance. You may need to work hard to make a cause and effect toy be more effective for language development, but the most important thing to remember is to have fun! They’ll only be this little for so long. Enjoy!

Childhood Developmental Milestones

As a speech-language pathologist, I am often sought after by friends and family to provide solid information on development. My go-to responses often include: one year-one word, two-word combinations by 18 months, and walking around a year. Early developing sounds include all vowels and consonants /b, p, m, t, d, k, g/ (within the first 2-3 years).

However, this is not a perfect science. In fact, there are several schools of thought in the research about the when of sound development. The Virginia Department of Education uses the Iowa Nebraska Articulation Norms in schools as a guide but then the Goldman-Fristoe Test of Articulation Norms present some discrepancies.

So what do we do? This seems far from NORMal. My rule of thumb is often to use these as a guide. When testing children, we need to have some kind of reference and we can think about early (those named above) vs. late (“th” and “r”) developing sounds.

Another important “milestone” that is a good measure of sound development comes within a child’s intelligibility. I usually think of the following numbers when it comes to intelligibility to an unfamiliar listener (parents and teachers are deemed “familiar listeners”) when context is unknown: by 2 years old a child should be about 50% intelligible; by 3 years old a child should be about 75% intelligible; and by 4 years old a child should be about 100% intelligible. Keep in mind that I don’t think anyone is always 100% intelligible – this will specifically happen on the phone, in a crowded and noisy room, or when someone mumbles. Remember, these numbers are just a guide to get a general idea, as all children develop differently.

In any case, I always recommend visiting a licensed speech-language pathologist to assess articulation if you have the slightest concern. “Mother knows best,” as they say so go with your instincts. It’s always better to be safe than sorry!